Myths
that will not die
False beliefs and wishful thinking about the human experience
are common. They are hurting people — and holding back science.
BY MEGAN SCUDELLARI
I
n 1997, physicians in southwest Korea
began to offer ultrasound screening for
early detection of thyroid cancer. News
of the programme spread, and soon phy-
sicians around the region began to offer the
service. Eventually it went nationwide, piggy-
backing on a government initiative to screen
for other cancers. Hundreds of thousands took
the test for just US$30–50.
Across the country, detection of thyroid
cancer soared, from 5 cases per 100,000 people
in 1999 to 70 per 100,000 in 2011. Two-thirds
3 2 2 | NAT U R E | VO L 5 2 8 | 1 7 D E C E M B E R 2 0 1 5
© 2015 Macmillan Publishers Limited. All rights reserved
of those diagnosed had their thyroid glands
removed and were placed on lifelong drug
regimens, both of which carry risks.
Such a costly and extensive public-health
programme might be expected to save lives.
ILLUSTRATIONS BY RYAN SNOOK
But this one did not. Thyroid cancer is now
the most common type of cancer diagnosed in
South Korea, but the number of people who die
from it has remained exactly the same — about
1 per 100,000. Even when some physicians in
Korea realized this, and suggested that thy-
roid screening be stopped in 2014, the Korean

Thyroid Association, a professional society
of endocrinologists and thyroid surgeons,
argued that screening and treatment were basic
human rights.
In Korea, as elsewhere, the idea that the early
detection of any cancer saves lives had become
an unshakeable belief.
This blind faith in cancer screening is an
example of how ideas about human biol-
ogy and behaviour can persist among peo-
ple — including scientists — even though the
scientific evidence shows the concepts to be
false. “Scientists think they’re too objective to
believe in something as folklore-ish as a myth,”
says Nicholas Spitzer, director of the Kavli
Institute for Brain and Mind at the University
of California, San Diego. Yet they do.
These myths often blossom from a seed
of a fact — early detection does save lives for
some cancers — and thrive on human desires
or anxieties, such as a fear of death. But they
can do harm by, for instance, driving people
to pursue unnecessary treatment or spend
money on unproven products. They can also
derail or forestall promising research by dis-
tracting scientists or monopolizing funding.
And dispelling them is tricky.
Scientists should work to discredit myths,
but they also have a responsibility to try to
prevent new ones from arising, says Paul
Howard-Jones, who studies neuroscience and
education at the University of Bristol, UK. “We
need to look deeper to understand how they
come about in the first place and why they’re
so prevalent and persistent.”
Some dangerous myths get plenty of air
time: vaccines cause autism, HIV doesn’t
cause AIDS. But many others swirl about, too,
harming people, sucking up money, muddying
the scientific enterprise — or simply getting
on scientists’ nerves. Here, Nature looks at the
origins and repercussions of five myths that
refuse to die.
MYTH 1: SCREENING SAVES LIVES FOR ALL
TYPES OF CANCER
Regular screening might be beneficial for some
groups at risk of certain cancers, such as lung,
cervical and colon, but this isn’t the case for all
tests. Still, some patients and clinicians defend
the ineffective ones fiercely.
The belief that early detection saves lives
originated in the early twentieth century,
when doctors realized that they got the best
outcomes when tumours were identified and
treated just after the onset of symptoms. The
next logical leap was to assume that the earlier
a tumour was found, the better the chance of
survival. “We’ve all been taught, since we were
at our mother’s knee, the way to deal with can-
cer is to find it early and cut it out,” says Otis
Brawley, chief medical officer for the American
Cancer Society.
But evidence from large randomized trials
for cancers such as thyroid, prostate and breast
has shown that early screening is not the
lifesaver it is often advertised as. For example,
a Cochrane review of five randomized
controlled clinical trials totalling 341,342 par-
ticipants found that screening did not signifi-
cantly decrease deaths due to prostate cancer1.
“People seem to imagine the mere fact that
you found a cancer so-called early must be a
benefit. But that isn’t so at all,” says Anthony
Miller at the University of Toronto in Can-
ada. Miller headed the Canadian National
Breast Screening Study, a 25-year study of
89,835 women aged 40–59 years old2 that
found that annual mammograms did not
reduce mortality from breast cancer. That’s
because some tumours will lead to death
irrespective of when they are detected and
treated. Meanwhile, aggressive early screen-
ing has a slew of negative health effects. Many
cancers grow slowly and will do no harm if
left alone, so people end up having unnec-
essary thyroidectomies, mastectomies and
prostatectomies. So on a population level,
the benefits (lives saved) do not outweigh the
risks (lives lost or interrupted by unnecessary
treatment).
“We cherry-pick
the numbers that
put us on top.”
Still, individuals who have had a cancer
detected and then removed are likely to feel
that their life was saved, and these personal
experiences help to keep the misconception
alive. And oncologists routinely debate what
ages and other risk factors would benefit
from regular screening.
Focusing so much attention on the current
screening tests comes at a cost for cancer
research, says Brawley. “In breast cancer,
we’ve spent so much time arguing about age
40 versus age 50 and not about the fact that
we need a better test,” such as one that could
detect fast-growing rather than slow-growing
tumours. And existing diagnostics should be
rigorously tested to prove that they actually
save lives, says epidemiologist John Ioannidis
of the Stanford Prevention Research Center
in California, who this year reported that
very few screening tests for 19 major diseases
actually reduced mortality3.
Changing behaviours will be tough. Gilbert
Welch at the Dartmouth Institute for Health
Policy and Clinical Practice in Lebanon, New
Hampshire, says that individuals would rather
be told to get a quick test every few years
than be told to eat well and exercise to pre-
vent cancer. “Screening has become an easy
way for both doctor and patient to think they
are doing something good for their health, but
their risk of cancer hasn’t changed at all.”
1 7 D E C E M B E R 2 0 1 5 | VO L 5 2 8 | NAT U R E | 3 2 3
© 2015 Macmillan Publishers Limited. All rights reserved
FEATURE NEWS
MYTH 2: ANTIOXIDANTS ARE GOOD AND FREE
RADICALS ARE BAD
In December 1945, chemist Denham
Harman’s wife suggested that he read an article
in Ladies’ Home Journal entitled ‘Tomorrow
You May Be Younger’. It sparked his interest
in ageing, and years later, as a research associ-
ate at the University of California, Berkeley,
Harman had a thought “out of the blue”, as he
later recalled. Ageing, he proposed, is caused
by free radicals, reactive molecules that build
up in the body as by-products of metabolism
and lead to cellular damage.
Scientists rallied around the free-radical
theory of ageing, including the corollary
that antioxidants, molecules that neutralize
free radicals, are good for human health. By
the 1990s, many people were taking anti-
oxidant supplements, such as vitamin C and
β-carotene. It is “one of the few scientific
theories to have reached the public: gravity,
relativity and that free radicals cause ageing,
so one needs to have antioxidants”, says Sieg-
fried Hekimi, a biologist at McGill University
in Montreal, Canada.
Yet in the early 2000s, scientists trying to
build on the theory encountered bewilder-
ing results: mice genetically engineered to
overproduce free radicals lived just as long as
normal mice4, and those engineered to over-
produce antioxidants didn’t live any longer
than normal5. It was the first of an onslaught
of negative data, which initially proved dif-
ficult to publish. The free-radical theory “was
like some sort of creature we were trying to
kill. We kept firing bullets into it, and it just
wouldn’t die,” says David Gems at University
College London, who started to publish his
own negative results in 2003 (ref. 6). Then,
one study in humans7 showed that antioxidant
supplements prevent the health-promoting
effects of exercise, and another associated
them with higher mortality8.
None of those results has slowed the global
antioxidant market, which ranges from food
and beverages to livestock feed additives. It is
projected to grow from US$2.1 billion in 2013
to $3.1 billion in 2020. “It’s a massive racket,”
 NEWS FEATURE
says Gems. “The reason the notion of oxidation
and ageing hangs around is because it is per-
petuated by people making money out of it.”
Today, most researchers working on ageing
agree that free radicals can cause cellular dam-
age, but that this seems to be a normal part of
the body’s reaction to stress. Still, the field has
wasted time and resources as a result. And the
idea still holds back publications on possible
benefits of free radicals, says Michael Ristow,
a metabolism researcher at the Swiss Federal
Institute of Technology in Zurich, Switzer-
land. “There is a significant body of evidence
sitting in drawers and hard drives that sup-
ports this concept, but people aren’t putting it
out,” he says. “It’s still a major problem.”
Some researchers also question the broader
assumption that molecular damage of any
kind causes ageing. “There’s a question mark
about whether really the whole thing should
be chucked out,” says Gems. The trouble, he
says, is that “people don’t know where to go
now”.
MYTH 3: HUMANS HAVE EXCEPTIONALLY
LARGE BRAINS
The human brain — with its remarkable
cognition — is often considered to be the
pinnacle of brain evolution. That dominance
is often attributed to the brain’s exceptionally
large size in comparison to the body, as well
as its density of neurons and supporting cells,
called glia.
None of that, however, is true. “We cherry-
pick the numbers that put us on top,” says Lori
Marino, a neuroscientist at Emory University
in Atlanta, Georgia. Human brains are about
seven times larger than one might expect rela-
tive to similarly sized animals. But mice and
dolphins have about the same proportions,
3 2 4 | NAT U R E | VO L 5 2 8 | 1 7 D E C E M B E R 2 0 1 5
MY TH S T H AT P E R S I ST
Irksome misbeliefs
Nature polled doctors and scientists for
the medical myths that they find most
frustrating. Here’s what turned up.
Vaccines cause autism
Although there are some risks
associated with vaccines, the connection
to neurological disorders has been
debunked many times over.
Paracetamol (acetaminophen) works
through known mechanisms
Although it is widely used, there are only
hints as to how it and other common
drugs actually work.
The brain is walled off from the immune
system
The brain has its own immune cells, and
a lymphatic system that connects the
brain to the body’s immune system has
recently been discovered.
Homeopathy works.
It doesn’t.
and some birds have a larger ratio.
“Human brains respect the rules of scaling.
We have a scaled-up primate brain,” says
Chet Sherwood, a biological anthropologist
at George Washington University in Washing-
ton DC. Even cell counts have been inflated:
articles, reviews and textbooks often state
that the human brain has 100 billion neurons.
© 2015 Macmillan Publishers Limited. All rights reserved
More accurate measures suggest that the
number is closer to 86 billion. That may sound
like a rounding error, but 14 billion neurons is
roughly the equivalent of two macaque brains.
Human brains are different from those of
other primates in other ways: Homo sapiens
evolved an expanded cerebral cortex — the
part of the brain involved in functions such as
thought and language — and unique changes
in neural structure and function in other areas
of the brain.
The myth that our brains are unique
because of an exceptional number of neurons
has done a disservice to neuroscience because
other possible differences are rarely investi-
gated, says Sherwood, pointing to the exam-
ples of energy metabolism, rates of brain-cell
development and long-range connectivity of
neurons. “These are all places where you can
find human differences, and they seem to be
relatively unconnected to total numbers of
neurons,” he says.
The field is starting to explore these topics.
Projects such as the US National Institutes of
Health’s Human Connectome Project and the
Swiss Federal Institute of Technology in Laus-
anne’s Blue Brain Project are now working to
understand brain function through wiring
patterns rather than size.
MYTH 4: INDIVIDUALS LEARN BEST
WHEN TAUGHT IN THEIR PREFERRED
LEARNING STYLE
People attribute other mythical qualities to
their unexceptionally large brains. One such
myth is that individuals learn best when they
are taught in the way they prefer to learn. A
verbal learner, for example, supposedly learns
best through oral instructions, whereas a vis-
ual learner absorbs information most effec-
tively through graphics and other diagrams.
There are two truths at the core of this myth:
many people have a preference for how they
receive information, and evidence suggests
that teachers achieve the best educational
outcomes when they present information in
multiple sensory modes. Couple that with peo-
ple’s desire to learn and be considered unique,
and conditions are ripe for myth-making.
“Learning styles has got it all going for it:
a seed of fact, emotional biases and wishful
thinking,” says Howard-Jones. Yet just like
sugar, pornography and television, “what you
prefer is not always good for you or right for
you,” says Paul Kirschner, an educational psy-
chologist at the Open University of the Neth-
erlands.
In 2008, four cognitive neuroscientists
reviewed the scientific evidence for and against
learning styles. Only a few studies had rigorously
put the ideas to the test and most of those that
did showed that teaching in a person’s preferred
style had no beneficial effect on his or her learn-
ing. “The contrast between the enormous pop-
ularity of the learning-styles approach within
education and the lack of credible evidence for its
utility is, in our opinion, striking and disturbing,”
the authors of one study wrote9.
That hasn’t stopped a lucrative industry from
pumping out books and tests for some 71 pro-
posed learning styles. Scientists, too, perpetuate
the myth, citing learning styles in more than
360 papers during the past 5 years. “There are
groups of researchers who still adhere to the
idea, especially folks who developed ques-
tionnaires and surveys for categorizing peo-
ple. They have a strong vested interest,” says
Richard Mayer, an educational psychologist
at the University of California, Santa Barbara.
In the past few decades, research into
educational techniques has started to show
that there are interventions that do improve
learning, including getting students to sum-
marize or explain concepts to themselves. And
it seems almost all individuals, barring those
with learning disabilities, learn best from a
mixture of words and graphics, rather than
either alone.
Yet the learning-styles myth makes it
difficult to get these evidence-backed con-
cepts into classrooms. When Howard-Jones
speaks to teachers to dispel the learning-styles
myth, for example, they often don’t like to hear
what he has to say. “They have disillusioned
faces. Teachers invested hope, time and effort
in these ideas,” he says. “After that, they lose
interest in the idea that science can support
learning and teaching.”

MYTH 5: THE HUMAN POPULATION IS GROWING

EXPONENTIALLY (AND WE’RE DOOMED)
Fears about overpopulation began with
Reverend Thomas Malthus in 1798, who pre-
dicted that unchecked exponential population
growth would lead to famine and poverty.
But the human population has not and is
not growing exponentially and is unlikely
to do so, says Joel Cohen, a populations
researcher at the Rockefeller University in
New York City. The world’s population is now
growing at just half the rate it was before 1965.
Today there are an estimated 7.3 billion peo-
ple, and that is projected to reach 9.7 billion
by 2050. Yet beliefs that the rate of popula-
tion growth will lead to some doomsday
scenario have been continually perpetuated.
Celebrated physicist Albert Bartlett, for exam-
ple, gave more than 1,742 lectures on expo-
nential human population growth and the dire
consequences starting in 1969.
The world’s population also has enough to
eat. According to the Food and Agriculture
Organization of the United Nations, the rate of
global food production outstrips the growth of
the population. People grow enough calories
in cereals alone to feed between 10 billion and
12 billion people. Yet hunger and malnutrition
persist worldwide. This is because about 55%
of the food grown is divided between feed-
ing cattle, making fuel and other materials or
going to waste, says Cohen. And what remains
is not evenly distributed — the rich have
plenty, the poor have little. Likewise, water
is not scarce on a global scale, even though
1.2 billion people live in areas where it is.
“Overpopulation is really not overpopu-
lation. It’s a question about poverty,” says
Nicholas Eberstadt, a demographer at the
American Enterprise Institute, a conserva-
tive think tank based in Washington DC. Yet
instead of examining why poverty exists and
how to sustainably support a growing popula-
tion, he says, social scientists and biologists
talk past each other, debating definitions and
causes of overpopulation.
Cohen adds that “even people who know
the facts use it as an excuse not to pay atten-
tion to the problems we have right now”,
pointing to the example of economic systems
that favour the wealthy.
Like others interviewed for this article,
Cohen is less than optimistic about the chances
of dispelling the idea of overpopulation and
other ubiquitous myths (see ‘Myths that per-
sist’), but he agrees that it is worthwhile to
try to prevent future misconceptions. Many
myths have emerged after one researcher
extrapolated beyond the narrow conclusions
of another’s work, as was the case for free radi-
cals. That “interpretation creep”, as Spitzer calls
it, can lead to misconceptions that are hard to
excise. To prevent that, “we can make sure an
extrapolation is justified, that we’re not going
beyond the data”, suggests Spitzer. Beyond
that, it comes down to communication, says
Howard-Jones. Scientists need to be effective
at communicating ideas and get away from
simple, boiled-down messages.
Because once a myth is here, it is often here
to stay. Psychological studies suggest that the
very act of attempting to dispel a myth leads
to stronger attachment to it. In one experi-
ment, exposure to pro-vaccination messages
reduced parents’ intention to vaccinate their
children in the United States. In another, cor-
recting misleading claims from politicians
increased false beliefs among those who
already held them. “Myths are almost impos-
sible to eradicate,” says Kirschner. “The more
you disprove it, often the more hard core it
becomes.” ■
Megan Scudellari is a science journalist in
Boston, Massachusetts.
1. Ilic, D., Neuberger, M. M., Djulbegovic, M. & Dahm, P.
Cochrane Database Syst Rev. 1, CD004720 (2013).
2. Miller, A. B. et al. Br. Med. J. 348, g366 (2014).
3. Saquib, N., Saquib, J. & Ioannidis, J. P. A.
Int. J. Epidemiol. 44, 264–277 (2015).
4. Doonan, R. et al. Genes Dev. 22, 3236–3241 (2008).
5. Pérez, V. I. et al. Aging Cell 8, 73–75 (2009).
6. Keaney, M. & Gems, D. Free Radic. Biol. Med. 34,
277–282 (2003).
7. Ristow, M. et al. Proc. Natl Acad. Sci. USA 106,
8665–8670 (2009).
8. Bjelakovic, G., Nikolova, D. & Gluud, C. J. Am. Med.
Assoc. 310, 1178–1179 (2013).
9. Pashler, H., McDaniel, M., Rohrer, D. & Bjork, R.
Psychol. Sci. Publ. Int. 9, 105–119 (2008).

1 7 D E C E M B E R 2 0 1 5 | VO L 5 2 8 | NAT U R E | 3 2 5
© 2015 Macmillan Publishers Limited. All rights reserved